How Counselling Works

Published on July 2, 2014

How does counselling work? Many people have asked this question and do not know. Some people formed predefined opinions about it without ever having tried it due to the unfortunate stigma attached to it. The stigma comes from a lack of understanding on how professional counselling works. For many other people they think: How can the therapist even help me? What new can they tell me?

Others, especially couples, may think counselling is a mini court of law, where the therapist sits in judgment, ruling on people’s behavior as to whether it is good or bad (FYI: we do not do this). Many Asian cultures have a very negative stigma about seeing a counsellor and apply the meaning that it is only for “someone who lacks common sense.”

Counselling, unfortunately, is this mysterious process where many people do not understand how it works and aretherefore reluctant to use it. Due to the confidential nature of counselling it can be difficulty to know what happens without first attending a session or two. That may a bit risky for some clients.

Therapy can be a very effective way for dealing with problems in a person’s life or relationship. Therapy can help people work through difficult choices and understand what they are the possible future ramifications of any decision. However, to be most effective, it helps to have the client understand how it works and what their responsibility is so that they can get the most out of it.

The purpose of this article is to hopefully clarify further how counselling works. It is intended to clarify what our therapist does and what the role of the client is. With this information, people can make a more informed choice to see if counselling is a good avenue for them to make better choices, resolve life problems. This article is about our therapist and her theoretical orientation. All therapist use different theories for their therapy and there no 2 therapist will look the same. This is about our therapist and her approach..

Where Counselling Fits

Counselling fills this unique space to help people understand the purpose of their behaviors and choices and determine if they are effective in getting them what they think they want. People usually know what to do to be physically healthy i.e. get enough sleep, exercise and eat a balanced diet. People know that you should be kind and monogamous to your spouse and not yell at your kids. Yet despite knowing this, people do not do it. This is where counselling comes in.

Counselling doesn't give advice but rather partners with people to explore the purpose to not choose the "right thing." Mental Health Counsellors help people become consciously aware of what they really want and figure out more healthy ways to get it. Counselling helps people understand their total choices and total behavior (thinking, believing and doing) so a person is aware of both the pros and the cons to every decision they choose to make or not make. Counselling helps people to align their intentions with their behaviors.

What Counsellors Do Not Do

As counsellors, our responsibility is to help clients examine what they want, but we do not nor can we make people do anything that the person doesn’t want to do.

Think about this, how can we? We have no legal power over the person. We are not going to call them or follow them home to enforce a decision by the client. In fact, we cannot control if the person comes in to our office.

It is up to the client to determine what they will choose to do or not. Our job is to help people see if what they doing or thinking or wanting is effective and realistic. We help them evaluate if they are getting what they want by their choices and behaviors and if not, to find alternatives choices, behaviors or ways of thinking that would be more effective. In the end the clients makes a choice to continue with the effective ways or choose to experiment with new ways.

Often, what people want is either unrealistic or it is not good for the person. If a person wants something that is unrealistic, chances are whatever behaviors or choices they make will not allow them to get this. Counsellors are not able to help people get unrealistic things. Instead, a counsellor will help a person examine what that unrealistic thing, whether a behavior, a choice or a relationship, represents and help them figure out something more realistic.

If someone wants something that is bad for him or her, a therapist is not in a position to stop them outright, for example with infidelity or drug use. It is not the therapist responsibility to make choices for a person. The client is the only person responsible for his or her behavior and choice. A therapist will help a client examine the purpose to choose something that that is bad and figure out if they want to keep choosing the harmful “it”. If not, the therapist will examine what alternatives there are. A therapist cannot stop or prevent someone from doing harmful things; that is the client’s choice and responsibility.

Therapists don’t give advice. Advice is something that you get for free from friends, family and spouses. Advice is often given with a personal motive or agenda of the giver. Instead a therapist is interested in helping a client determine what is in the client’s best interest and the tradeoffs (pros and cons) of any choice or behavior.

In relationship and marriage counselling, many people think that the therapy is a mini court of law with the therapist playing judge ready to listen to both side and rule one party the winner and the loser. The therapist does not do this.

Even if the therapist could rule, s/he has no power to enforce his or her ruling. Therapists only have as much power and information as the couple gives to the therapist. Instead, the therapist is helping people clarify what they want, determine if it is realistic and then develop the skills needed to get what they want. The therapist isn’t interested in right or wrong, which are highly subjective to the client or couple’s reality. The mental health counsellor is most interested in HOW couples build solutions and a life together so that both people are happy with the outcome.

Client Responsibility

Mental Health counsellors can be highly effective across multiple domains and cultures precisely because we do not give advice. Therapy is a partnership in which the client is responsible for about 60% of their outcome for the goals for their therapy. Unlike a massage which is done to you and you just sit back and relax or surgery which is performed by the surgeon and you just need to bring the body, therapy is a joint effort. The therapist can only give the client information based on what the client chooses to share. Also if the client chooses not to share certain information and the therapist doesn’t have this information, it makes it harder for the therapist to help the client.

Clients bring in all the knowledge about their lives, relationships, family, career, culture, religion and socioeconomic status. Clients are the only ones that can determine right or wrong, good or bad in the context of their life. Hence, client is a very individual and unique experience. It is customize to each client or couple that comes in. The client is very active in the process sharing how things work, how they make decisions and what they want.

The therapist partner’s with the client and helps them look at how they are making decisions or choices to get what they want. The therapist, along with the client, examines beliefs and expectations held that drive behaviors and choices. Therapist is able to leverage the client’s knowledge about their own life and help them look at it differently to see if what they want is realistic and good. Clients get new “eyes” to see if what they are doing to get what they want is effective. When it is not, the therapist and client work together to come up with alternatives. So the client needs to be prepared to participate and think about their thoughts, behaviors, choices and beliefs.

So a client needs to be prepared and responsible for their therapy. Therapy is built around the premise of change. Most people are not crazy about change, but if the change can offer a more satisfying life or a relationship people can be motivated. Therapy is also challenging. It is really challenging to look at one’s own behavior and choices and beliefs from a different perspective. So having a good relationship with a therapist is important.

What Therapist Does

Mental Health counsellors partner with the client or couple to get them to look at their own behaviors, choices, thoughts and beliefs with “new eyes” to see if what they are doing or thinking is effective in getting what they want and if what they want is realistic.

One of the toughest things for people to do is evaluate their own actions, thoughts, beliefs and choices. We are very good at looking at other people’s choices, behaviors or thoughts and evaluating them and passing judgment. But doing this to ourselves is very difficult because our natural defense mechanism such as denial, rationalization, justification, depression, anxiety, compulsive masturbation or drug and alcohol use to name a few.

Because mental health counsellors are leveraging the domain expertise of the clients, we are able to cut across a wide section of problems, life situation, religions, cultures and relationships. We take our knowledge of human behavior, how the brain works, systems, mental health problems and use them with the client’s knowledge about their own life. Together we help clients see patterns of behaviors or choices. We help clients determine if they are being effective by asking the client to self-evaluate in new ways the client never considered. All this collaboration helps clients develop alternative solutions to existing problems.

Tagging on to this, counsellors or therapist do not tell people what to do or what is the right thing. That is the client’s responsibility. Instead the therapist feedback what the client has already told us about what they want, how their life works and the choices they are making and help the client to evaluate the effectiveness and appropriateness of all these factors.

One of the biggest jobs a therapist does is to help clients or couples CORRECTLY define the problems. Many times clients come thinking they know what the problem is and then they want a fast solution to fix it. This incorrect assumption of counselling implies that 1. The client knows how to correctly identify and define their problem, which often do not and hence the reason they are stuck 2. That there is some simple formula or recipe type solution to the problem. 3. That the client conceptualization of the problem is simple.

Counselling is not a secret repository of “recipe” solutions that the mental health counsellor is a keeper of. Human beings and relationships are not like baking a cake that if you follow simple steps you get a great product.

No two couples or clients problems are the same. Depression doesn’t work the same in all people or have the same cause. Anxiety acts differently in all people. All relationships have different strengths and weakness and issues. While at a macro level we are able to study behaviors, patterns and outcomes, counselling is providing customized solutions but it requires the active participation of the client to help work out what is the client really wants and what is really going on.

Therapists are also teachers. We teach people more effective mental health skills. These cover a wide range from dealing with decision making, parenting, conflict resolution in relationships, how to deal with loss and grief. We provide help people become more effective in their lives but we need the client’s participation.

A client will only get out of therapy what they are willing to risk by sharing their thoughts, beliefs and actions to therapist. If a client doesn’t participate or talk, the therapist has nothing to work with. Therapy happens outs of the therapy room with the client practicing their new skills which might be behavioral or thinking in nature. The client is responsible for practicing and implementing what they learn and talk about in session and report back at the next session.

If you are interested in counselling and not sure how it can help, we are happy to answer your questions. Or better yet you can read our articles to learn more about how our therapy works.

Written by:

Tammy M. Fontana, MS NCC CTRT Sex Therapist USA

Ms. Fontana is a relationship counsellor specializing in helping people with their relationships whether it is dating, marriage, parenting or with their extended family. Her clients call her approach practical and found solutions to their problems. Ms. Fontana has obtained her Master Degree in Mental Health counselling from the United States and is a USA Nationally Certified Counsellor. She is also a Certified Choice Theory Reality Therapist and is USA trained Sex Therapist.